Case report: Is bilateral renal dioctophymosis and severe uremia in a dog synonymous of euthanasia? Not today.

A dog with bilateral renal dioctophymosis presented with stage 5 acute kidney injury, weight loss, vomiting, apathy, and hematuria. Laboratory tests showed creatinine of 17.2 mg/dL and Dioctophyme renale eggs in the urine. It underwent a 30-min session of hyperbaric oxygen preconditioning at a pressure of 2 ATA. Subsequently, bilateral nephroscopy was performed, without warm ischemia, using Amplatz-type renal dilators. Five parasites were removed, three females from the right kidney, one female from the left kidney, and one male from the abdominal cavity. After surgery, the patient continued doing daily hyperbaric oxygen therapy (HBOT) sessions and clinical therapy. Postoperative care consisted of analgesics, antimicrobials, antioxidants, gastric protector and fluid therapy. Ultrasound monitoring showed a reduction in the area of renal dilation and the hematological and biochemical tests showed rapid recovery from acute kidney injury. There was no bacterial growth in the urine sample collected directly from the kidneys. The patient had an excellent clinical progression and was discharged from hospital 7 days postoperatively, with creatinine values of 2.9 mg/dL. This is the first report of the use of nephroscopy in the treatment of dioctophymosis and indicates excellent chances of cure even in severe cases of bilateral parasitosis. HBOT was shown to be an ally in the clinical therapy of patients with D. renale by helping with stabilization and postoperative recovery.

First record of Dioctophyme renale (Goeze, 1782) in the pampas fox (Lycalopex gymnocercus, Fischer, 1814) (Carnivora: Canidae).

Dioctophyme renale (Goeze 1782) has not previously been reported in the pampas fox (Lycalopex gymnocercus) (Fisher 1814), the most abundant canid of southern South America. A wild adult pampas fox female was found dead due to unknown causes in Santa Fe province, Argentina. Post-mortem examination revealed three red worms measuring 10, 11 and 15 cm long, each with an approximate width of 5 mm. All of them were found free in the abdominal cavity. The worms were all male and were identified through morphological examination and molecular analysis as D. renale. No worm was found in the kidneys. This study reports the first case of dioctophymatosis in the pampas fox in Argentina, increasing the range of wild aberrant host species infected by the giant kidney worm in the Neotropical region.

Nephrectomy in 52 dogs for the treatment of Dioctophyme renale infection - Knowing the enemy to win.

Dioctophyme renale (D. renale) is a nematode that parasitizes the kidney of mammals. Treatment is often surgical, with removal of the affected organ. This retrospective study aims to evaluate the epidemiological, clinical, and surgical aspects, the interval between diagnosis and treatment, the occurrence of pre- and intraoperative complications, and the postoperative survival time of dogs parasitized by D. renale undergoing therapeutic nephrectomy. Records of fifty-two dogs treated in a single hospital service were analyzed. We collected epidemiological data, laboratory results, diagnostic method, anesthetic protocol, surgical technique and time, type of antimicrobial prophylaxis, pre- and intraoperative complications, location and number of parasites, and postoperative survival time. Of the 52 dogs undergoing right nephrectomy by laparotomy, 61.5 % were female and 63.4 % were adults. Although the most common clinical sign was hematuria (25 %), 61.5 % of the patients were asymptomatic. Eosinophilia and increased serum urea were the only laboratory changes found. The interval between diagnosis and surgery was 27.4 ± 23 days and no patient showed changes suggestive of surgical emergency. The most common surgical approach was the right paracostal (61.5 %), and a continuous suture pattern was predominant. Intraoperative complications occurred in 9.6 % of the procedures, varying from mild to severe hemorrhage. Mean postoperative survival was 835.5 ± 428 days. Dioctophymosis was effectively controlled by nephrectomy of the affected kidney, allowing a mean survival of more than 830 days. No serious complications caused by intervals between diagnosis and treatment have been reported. This is the largest retrospective study evaluating dogs infected with D. renale that were surgically treated.

Tracking the existence of Dioctophyma renale in Parthian Empire of Iran (247 BC-224 AD).

Paleoparasitological investigation in the archeological site of the Caspian Sea littoral revealed the presence of human Dioctophyma renale infection, a ubiquitous kidney-residing helminth of mammals, during the Parthian Empire of Iran (247 BC-224 AD). This study reports the oldest human infection with giant kidney worm in the Middle East, mainly in an area where the infection is reported nowadays. The paucity of records throughout the literature suggests that the same species of parasite occurred with low frequency in the past, as well. The cemetery in the archeological site of Kiasar represented a unique opportunity of studying human and animal parasites of the Parthian Empire in Iran.

REVIEW OF DIOCTOPHYME RENALE: ETIOLOGY, MORPHOLOGY, BIOLOGY, ECOEPIDEMIOLOGY, PATHOGENESIS, SYMPTOMATOLOGY, DIAGNOSIS, TREATMENT, AND PREVENTION.

Dioctophyme renale has a worldwide distribution and has been diagnosed in several wild and domestic animals as well as in humans. As numerous reports in the literature exist concerning the presence of D. renale in different animal species, as well as its diagnosis, treatment, and confirmation in new geographic areas, we reviewed existing information to contribute to the knowledge of the etiology, biology, epidemiology, pathogenesis, symptoms, diagnosis, treatment, and prevention of D. renale. Results of dioctophymosis may range from asymptomatic infection to even death of the host. Diagnosis is based on data from morphology, imaging, and antibody testing, with surgical treatment being the most effective. A high potential for infection of pets exists when there is overlap with wild parasitized animals; given common risk factors for infections in humans, D. renale should be considered as having zoonotic potential.

GIANT RED KIDNEY WORM (DIOCTOPHYMA RENALE) INFECTION IN PUPPIES LESS THAN FOUR MONTHS OF AGE FROM NORTHERN CANADA.

In this article, we present 2 case reports of puppies less than 4 mo of age at the time of infection with the nematode known as giant red kidney worm (Diotophyma renale). The first puppy was prepared for an ovariohysterectomy that evolved into an exploratory laparotomy. An inflamed omentum was observed, and D. renale infection was suspected due to the puppies' place of origin. The algorithm developed by the Ontario Society for the Prevention of Cruelty to Animals for the diagnosis and treatment of D. renale infections in dogs was followed. Both puppies had a history of origin from northern Manitoba, Canada. Due to the puppies' ages, the authors suspect that the transmission of infection for both puppies could be transmammary, transplacental, or ingestion of paratenic hosts or that these cases challenge what is thought to be the current prepatent period. In addition, D. renale infections in dogs, especially from northern communities, could be common.

Occurrence of Dioctophyme renale (Goeze, 1782) in road-killed canids of Iran and its public health implication.

Dioctophyme renale, is the largest of parasitic nematodes, which infects different species of fish-eating carnivores worldwide. The northern provinces of Iran (Guilan and Mazandaran) located in south of the Caspian Sea are suitable for parasitic infections due to the mild and humid climatic conditions. From separate surveys of road-killed canids in various parts of the Caspian Sea littoral area in Iran, 70 carcasses were collected along the roads of Guilan and Mazandaran from 2015 to 2017. Dioctophyme renale detected by direct observation and molecular methods based on Cytochrome c oxidase subunit 1 (COX1 gene) sequencing analysis. Molecular investigation was also performed to validate prevalence and reduce false negative concerns. Dioctophyme renale was found in eight of 70 carnivores, mostly in the right kidneys, as well as two cases in the abdominal cavity of a dog and a golden jackal. More carcasses on the roads were seen with lacerated internal organs. Given the frequent number of giant kidney worms in canids in the region, the transmission of this zoonotic helminth to humans seems possible, since the area is a tourism hub in the country. The infection burden of this helminth should be investigated using DNA analysis of kidney tissue of road-killed carnivores in Iran.

Giant Red Kidney Worm (Dioctophyma renale) Screening and Treatment Protocol and Aberrant Worm Migration In Dogs From Ontario and Manitoba, Canada.

The life cycle of Dioctophyma renale involves an intermediate host (oligochaete), a paratenic hosts (fish and frogs), and a definitive host (mustelids and canids). Dogs are at risk of infection with D. renale when they consume paratenic hosts infected with the larval form of D. renale. Water containing the oligochaete intermediate host cannot be disregarded as another source of infection. Infections occur mainly in the right kidney, but worms have also been found in the abdominal cavity as well as other organs. Most dogs appear asymptomatic and infections are usually noted as incidental findings on necropsy. Recently, the Ontario Society for the Prevention of Cruelty to Animals (SPCA) and Humane Society conducted transports of dogs located in northern remote communities. In 2016, some female dogs were found to be infected with D. renale upon ovariohysterectomy. In response to this discovery, we developed a screening protocol to screen for D. renale infections. In 2018, a total of 130 intact dogs were transferred from 2 northern communities in the provinces of Ontario and Manitoba. A prevalence of 7.94% (95% confidence interval 3.87-14.11%) was found from dogs from the northern communities. The screening protocol we developed provides a method of screening for dogs that are transported from communities that could be at risk of infection with D. renale.

Dioctophymosis in a free-ranging maned wolf (Chrysocyon brachyurus): clinical-therapeutic, ultrasonographic and pathological aspects - case report / [Dioctofimose em um lobo guará (Chrysocyon brachyurus) de vida livre: aspectos clínico-terapêuticos, ultrassonográficos e patológicos - relato de caso]

Dioctophymosis is the disease caused by Dioctophyma renale, a large nematode, popularly known as giant kidney worm, and whose definitive hosts are the domestic dog and many wild mammal species. There are some reports of maned wolf parasitism by D. renale, however, in most cases the reports are restricted to the finding of the parasite during necropsy, without clinical assessment. The present report aimed to describe the clinical-therapeutic, ultrasonographic and pathological aspects of D. renale parasitism in a free-ranging maned wolf, emphasizing the treatment with an association of doramectin, praziquantel, pyrantel pamoate, and febantel that resulted in complete elimination of the parasite.(AU)

A dioctofimose é a doença causada pelo Dioctophyma renale, um nemátodo grande, popularmente chamado de verme gigante do rim e que tem como hospedeiro definitivo o cão doméstico e inúmeras espécies de mamíferos silvestres. Existem alguns relatos do parasitismo do lobo-guará por D. renale, contudo, na maioria das vezes, os relatos se restringem apenas ao achado do parasita durante a necropsia, sem a correlação clínica. O presente relato objetiva descrever os aspectos clínico-terapêuticos, ultrassonográficos e patológicos do parasitismo por D. renale em um lobo-guará de vida livre, enfatizando o tratamento com uma associação de doramectina, praziquantel, pamoato de pirantel e febantel, o que resultou na eliminação completa do parasita.(AU)

Ectopic Dioctophyme renale in the thoracic and abdominal cavities associated with renal parasitism in a dog.

Dioctophymosis is the disease caused by the nematode Dioctophyme renale, normally found parasitizing the right kidney of dogs. The absence of symptoms is frequent in parasitized animals. The surgical procedures are commonly performed to treat this disease. This work describes a case involving a canine with renal and ectopic parasitosis in the abdominal and thoracic regions. A mixed-breed female dog, approximately four months old, was diagnosed by ultrasound as for the presence of D. renale in the right kidney and abdominal and thoracic cavities. The animal underwent exploratory celiotomy, nephrectomy of the parasitized kidney, and transdiaphragmatic thoracotomy to remove the thoracic parasite, with a single abdominal surgical wound and excellent postoperative recovery. Several reports of ectopic parasitosis are found, however, the thoracic finding is unusual, and curative therapeutic transdiaphragmatic thoracotomy for dioctophymosis in dogs has not been previously described.

Occurrence of Dioctophyme renale larvae (Goeze, 1782) (Nematoda: Enoplida) in a new host from southern Brazil / Novo hospedeiro de larvas de Dioctophyme renale (Goeze, 1782) (Nematoda: Enoplida) no extremo sul do Brasil

Abstract Dioctophymatosis is caused by the giant kidney worm Dioctophyme renale which occurs in dogs, cats, and wild mammals. In Brazil, the disease has been diagnosed in dogs from several states around the country. In the present study, the occurrence of D. renale larvae in snakes from southern of Brazil is reported. Three specimens of Philodryas patagoniensis (Serpentes: Dipsadidae) (common names in Brazil: "parelheira", "papa-pinto") roadkill in the county of Capão do Leão, State of Rio Grande do Sul, southern Brazil, were necropsied. Two third-stage larvae of D. renale were found in the coelomic cavity of P. patagoniensis. This study reveals a new host for D. renale larvae in the southern region of the State of Rio Grande do Sul, Brazil. This particular geographic area of the country has stood out as several cases of D. renale infection have been reported in a number of vertebrates from this region including domestic dogs and cats and wild animals such as carnivores, fish, and freshwater turtles.

Resumo Dioctophyme renale, verme gigante do rim, parasita cães, gatos e mamíferos silvestres, sendo que no Brasil, a dioctofimatose canina vem sendo diagnosticada em diversos estados brasileiros. O estudo tem por objetivo registrar larvas de D. renale parasitando serpente no extremo sul do Brasil. Nesse contexto, foram examinados três espécimes de Philodryas patagoniensis (Serpentes: Dipsadidae) encontradas mortas após atropelamento em uma estrada do município de Capão do Leão, Rio Grande do Sul (RS). Duas larvas de terceiro estágio de D. renale foram encontradas na cavidade celomática de P. patagoniensis, a qual representa um novo hospedeiro para larvas de D. renale na região sul do RS, a qual vem se destacando devido aos diversos registros do parasito em cães e gatos domésticos, bem como animais silvestres (carnívoros, peixes, quelônios).

Dioctophyme renale: prevalence and risk factors of parasitism in dogs of São Cristóvão district, Três Barras county, Santa Catarina State, Brazil / Dioctophyme renale: prevalência e fatores de risco de parasitismo em cães no distrito de São Cristóvão, Três Barras, Santa Catarina, Brasil

Abstract Dioctophyme renale is a nematode that can be found parasitizing the kidney, peritoneal cavity and, rarely, other organs of canids and mustelids. This disease has high occurrence in the municipality of Três Barras, state of Santa Catarina, thus making this an interesting area to study the epidemiological aspects of infection by D. renale in dogs. Among 197 dogs, 14.2% showed the parasite eggs in urine and 16.4% showed IgG antibodies anti-D. renale in serum samples according to the indirect ELISA method; among seropositive dogs, 15 (37.5%) animals did not show any parasite eggs in their urine. Parasitism was more frequent in females, and there was no finding of interference from age on parasitism. Factors such as water potential and presence of paratenic hosts in the studied region were reported by the owners of dogs and may have contributed to the occurrence of parasitism.

Resumo Dioctophyme renale é nematoda parasita de rins, cavidade peritoneal e, mais raramente, de outros órgãos de canídeos e mustelídeos. Esta parasitose tem ocorrência elevada no Município de Três Barras - SC, tornando essa área interessante para o estudo de aspectos epidemiológicos da infecção por D. renale em cães. De 197 cães examinados, 14,2% apresentaram ovos do parasita na urina e 16,4% apresentaram anticorpos IgG anti-D. renale no soro pelo método de ELISA indireto e, entre estes, 15 (37,5%) não apresentavam ovos do parasita sendo eliminados pela urina. O parasitismo foi mais frequente nas fêmeas, e não houve constatação de interferência da idade no parasitismo. Fatores como potencial hídrico e presença de hospedeiros paratênicos na região estudada foram relatados pelos tutores dos cães e podem contribuir para a ocorrência do parasitismo.

Dioctophyme renale (Nematoda: Enoplida) in domestic dogs and cats in the extreme south of Brazil / Dioctophyme renale (Nematoda: Enoplida) em cães e gatos domésticos no extremo sul do Brasil

Abstract Dioctophyme renale is a zoonotic nematode that parasites the kidneys of wild and domestic carnivores, and it has been reported frequently in Brazil. The aim here was to register the number of cases of dogs and cats diagnosed with dioctophymosis by necropsy (1981 to 2014) and ultrasound examination (2010 to 2015) in Pelotas-RS. In this context, a survey was conducted on dioctophymosis cases diagnosed at the Veterinary Pathology Laboratory (LPV) and Veterinary Clinical Hospital (HCV) of the Federal University of Pelotas (UFPel), and at a specialist veterinary imaging diagnostics clinic. In total, 95 cases were registered. The high series of the disease in dogs can be related to the presence of a large number of stray and semi-domestic dogs in the city, and also due to the ingestion of intermediate hosts of D. renale parasitized with the infective larvae. Thus, it can be concluded that Pelotas is a city with favorable conditions for the occurrence of dioctophymosis with high rate of disease in recent years.

Resumo Dioctophyme renale é um nematódeo zoonótico que parasita principalmente o rim de carnívoros silvestres e domésticos, e tem sido relatado com frequência no Brasil. Objetivou-se registrar o número de casos de cães e gatos diagnosticados com dioctofimatose por necropsia (1981 a 2014) e exame ultrassonográfico (2010 a 2015) em Pelotas-RS. Nesse contexto, foi realizado um inquérito de casos de dioctofimatose em animais de companhia no Laboratório de Patologia Veterinária (LPV) e no Hospital de Clínicas Veterinária (HCV) da Universidade Federal de Pelotas (UFPel), e em uma clínica veterinária especializada em diagnóstico por imagem, totalizando 95 casos registrados. A elevada casuística da doença em cães pode estar relacionada à presença de um grande número de cães errantes e semi-domiciliados na cidade, e também devido à ingestão dos hospedeiros intermediários de D. renale parasitados com a larva infectante. Assim, conclui-se que Pelotas é uma cidade propícia para a ocorrência de dioctofimatose, com elevada casuística da doença nos últimos anos.